Psychopathology[a] is the scientific study of mental disorders, including efforts to understand their genetic, biological, psychological, and social causes; effective classification schemes (nosology); course across all stages of development; manifestations; and treatment.
As the study of psychiatric disorders
The scientific discipline of psychopathology was founded by Karl Jaspers in 1913, whose object of study was "mental phenomena".
Many different professions may be involved in studying mental disorders or distress. Most notably, psychiatrists and clinical psychologists are particularly interested in this area and may either be involved in clinical treatment of mental illness, or research into the origin, development and manifestations of such states, or often, both.
More widely, psychopathology may be involved in many different specialties. For example, a neuroscientist may focus on brain changes related to mental illness. Therefore, someone who is referred to as a psychopathologist, may be one of any number of professions who have specialized in studying this area.
Psychiatrists in particular are interested in descriptive psychopathology, which has the aim of describing the symptoms and syndromes of mental illness. This is both for the diagnosis of individual patients (to see whether the patient's experience fits any pre-existing classification), or for the creation of diagnostic systems (such as the Diagnostic and Statistical Manual of Mental Disorders or International Statistical Classification of Diseases and Related Health Problems) which define which signs and symptoms should make up a diagnosis, and how experiences and behaviours should be grouped in particular diagnoses (e.g. clinical depression, paraphrenia, paranoia, schizophrenia).
Before diagnosing a psychological disorder, clinicians must study the themes, also known as abnormalities, within psychological disorders. The most prominent themes consist of: deviance, distress, dysfunction and danger. These themes are known as the four Ds, which define abnormality.
The four Ds
A description of the four Ds when defining abnormality:
Deviance: this term describes the idea that specific thoughts, behaviours and emotions are considered deviant when they are unacceptable or not common in society. Clinicians must, however, remember that minority groups are not always deemed deviant just because they may not have anything in common with other groups. Therefore, we define an individual's actions as deviant or abnormal when his or her behaviour is deemed unacceptable by the culture he or she belongs to.
Distress: this term accounts for negative feelings by the individual with the disorder. He or she may feel deeply troubled and affected by their illness.
Dysfunction: this term involves maladaptive behaviour that impairs the individual's ability to perform normal daily functions, such as getting ready for work in the morning, or driving a car. Such maladaptive behaviours prevent the individual from living a normal, healthy lifestyle. However, dysfunctional behaviour is not always caused by a disorder; it may be voluntary, such as engaging in a hunger strike.
Danger: this term involves dangerous or violent behaviour directed at the individual, or others in the environment. An example of dangerous behaviour that may suggest a psychological disorder is engaging in suicidal activity.
As mental symptoms
The term psychopathology may also be used to denote behaviors or experiences which are indicative of mental illness, even if they do not constitute a formal diagnosis. For example, the presence of a hallucination may be considered as a psychopathological sign, even if there are not enough symptoms present to fulfill the criteria for one of the disorders listed in the DSM or ICD.
In a more general sense, any behaviour or experience which causes impairment, distress or disability, particularly if it is thought to arise from a functional breakdown in either the cognitive or neurocognitive systems in the brain, may be classified as psychopathology. It remains unclear how strong the distinction between maladaptive traits and mental disorders actually is, e.g. Neuroticism is often described as the personal level of minor psychiatric symptoms.
Diagnostic and Statistical Manual
The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is an official guideline for the diagnosis of psychological disorders. Clinicians, researchers and psychologists use this manual as a reference guide to diagnose psychological disorders.
Formerly, for a diagnosis to be made, 2 levels of criteria within the DSM must be met. First, the disordered behavior must originate within the person, and it must not be a reaction due to external factors. Second, the disorder must be involuntary, meaning that the individual cannot physically or mentally control their symptoms.
Current diagnostic criteria within the DSM does not recognize this requirement. Instead, it recognizes that specific diagnoses may indeed be reactions to environmental or external factors (e.g. Post Traumatic Stress Disorder). The DSM-5 uses specific diagnostic criteria for each individual disorder listed within. Many disorder descriptions within do make the distinction that specific symptomatic criteria cannot be the result of medication or drug side effects, but this is mostly to segregate diagnoses, as there are specific diagnoses for conditions caused by drugs or medications. Additionally, mental control is no longer a factor, as conditions such as Obsessive Compulsive Disorder have elements that, while precipitated by involuntary compulsions, are marked with an element of agency and choice.
Examples of Disorders classified within the DSM include:
- Major Depressive Disorder is a mood disorder defined by symptoms of loss of motivation, decreased mood, lack of energy and thoughts of suicide.
- Bipolar Disorders are mood disorders characterized by depressive and manic episodes of varying lengths and degrees.
- Dysthymia is a mood disorder similar to depression. Characterized by a persistent low mood, Dysthymia is a less debilitating form of depression with no break in ordinary functioning.
The previous version, the DSM-IV TR, uses a multi-axial system of classification, which requires the individual to be placed on 5 separate axes which describe possible mental health factors. Most disorders are recorded on axis I, which are state dependent. Axis II describes disorders that are trait dependent. Axis III describes current physical conditions, Axis IV describes psychosocial or environmental stressors, and lastly, Axis V is used to discuss the individuals global assessment of functioning.
- Axis I: Most psychological disorders
- Axis II: Personality disorders and mental retardation
- Axis III: General medical condition
- Axis IV: Psychosocial and environmental stressors
- Axis V: Global assessment of functioning
The current version, the DSM-5 no longer uses an axis system to diagnose individuals. The DSM-5 instead uses a thorough system of diagnostic criteria that accounts for comorbidity and differential diagnoses.
- Abnormal psychology
- Animal psychopathology
- Biological psychopathology
- Child psychopathology
- Chemical imbalance theory
- Clinical psychology
- To provide a richer understanding of what is meant by psychopathology, particularly the phenomonelogy (internal experience) of those afflicted with a mental disorder, consider the word's etymology. Psychopathology is derived from three roots: (1) psyche (noun), from Ancient Greek ψυχή (psukhē, "soul, breath, mind, life-breath, spirit"). (2) pathos (noun), from Ancient Greek πάθος, which is from πάσχω (paskhō, "I feel, suffer"), and in this context means a condition or state in which the individual experiences pain, suffering, death, misfortune, or misery. (3) -ology (suffix), from Ancient Greek -λογία -logia, the study of (see pathology). Thus, psychopathology is the scientific study of a mental condition wherein the individual suffers significant pain and misery, even to the point that they feel as if their very "life-breath" (soul) is being damaged or sucked out of them.
- "Etymology of psyche". Ancient Greek. Wiktionary. Retrieved 4 January 2014.
- "Etymology of pathos". Ancient Greek. Wiktionary. Retrieved 4 January 2014.
- Ormel, J., Laceulle, O.M., Jeronimus, B.F. (2014). "Why Personality and Psychopathology Are Correlated: A Developmental Perspective Is a First Step but More Is Needed". European Journal of Personality 28 (4): 396–98.
- Ormel J.; Jeronimus, B.F.; Kotov, M.; Riese, H.; Bos, E.H.; Hankin, B. (2013). "Neuroticism and common mental disorders: Meaning and utility of a complex relationship". Clinical Psychology Review 33 (5): 686–697. doi:10.1016/j.cpr.2013.04.003.
- Atkinson, L et al. (2004). Attachment Issues in Psychopathology and Intervention. Lawrence Erlbaum.
- Berrios, G.E.(1996) The History of Mental Symptoms: Descriptive Psychopathology since the 19th century. Cambridge, Cambridge University Press, ISBN 0-521-43736-9
- Freud, S (1916) The Psychopathology of Everyday Life. MacMillan.
- Keating, D P et al. (1991). Constructivist Perspectives on Developmental Psychopathology and Atypical Development. Lawrence Erlbaum.
- Maddux, J E et al. (2005). Psychopathology: Foundations for a Contemporary Understanding. Lawrence Erlbaum.
- McMaster University. (2011). Psychological disorders. In Discover psychology (pp. 154–155, 157-158, 162-164) [Introduction]. Toronto, ON: Nelson Education.
- Roudinesco, Élisabeth, Why Psychoanalysis?, New York, Columbia University Press, 2003
- Roudinesco, Élisabeth and Michel Plon, Dictionnaire de la Psychanalyse, Fayard, Paris, 2000
- Sims, A. (2002) Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier. ISBN 0-7020-2627-1
- Widiger, T A et al. (2000). Adult Psychopathology: Issues and Controversies. Annual Review of Psychology.